التفاصيل البيبلوغرافية
| العنوان: |
Spätergebnisse nach Oberschenkelschaftfrakturen im Kindesalter. |
| Alternate Title: |
Late results of children with fractures of the femur shaft. (English) |
| المؤلفون: |
Hofmann, S., Kap-herr, v., Fischer, U., Zügel, N., Engelskirchen, R. |
| المصدر: |
Unfallchirurgie; Jan1985, Vol. 11 Issue 1, p28-32, 5p |
| Abstract (English): |
The results of 102 children with fractures of the femur shaft treated by osteosynthesis with dynamic compression plates (DCP) in comparison to 87 children which underwent a conservative treatment by extension are presented. Of 329 patients in a 15-years period, 238 children had a follow-up examination with evaluable data and 49 patients were excluded because of a different therapy such as plaster traction, cast, osteosynthesis with srews or nails etc. The children were divided into two groups: series I from 1968 to 1977 and series II from 1978 to 1982. 19.6% of the patients had a residual difference of more than 1 cm in the length of the legs. Operated children were twice as often afflicted as the conservative group. The amount of difference in the length depended on the duration of instability and increased when several repositions were required in the conservative group, or when an operation was carried out secondary to inadequate traction therapy. Axial deviation was found to be much more common in the extended group (16.1%) than in the operated group, in which only 4% axial deviations persisted in series II when DC-plates were used exclusively. Predominant in the conservative group was a persisting antecurvation in 13 of 14 children. Residual rotation malatiqnment of significant degree was found oinly in the group treated by extension, while the operatedgroupaverosedat minortorsion deformities. Children with closed epiphysis on the data of examination, who had a persisting rotation failure, had been treated nearly exclusively by extension (50% versus 15%). severe complications such as refractures (10 patients), local wound infection (3 children) and osteomyelitis (1 patient) were only seen in the operated group, but decreased in the last years (series II) because of enhanced experience and better materials. Summarizing these results we fell that osteosynthesis with a DC-plate is an adequate procedure in the treatment of fractures of the femur shaft in children, providing the advantages of better anatomical reconstruction, earlier mobilisation of the children, and superior late results in comparison to traction therapy. [ABSTRACT FROM AUTHOR] |
| Abstract (German): |
Von den 329 in den Jahren 1968 bis 1982 behandelten Kindern unter 15 Jahren mit einer Oberschenkelschaftfraktur konnten 238 nachuntersucht werden. Ausgewertet wurden nur die Daten der mit Druckplattenosteosynthese versorgten Kinder (n=102) und der mittels Extension behandelten Kinder (n=87), um das Verhalten des kindlichen Oberschenkels nach einer Fraktur bezüglich der beiden Behandlungsverfahren zu verfolgen. Verbliebene Beinlängendifferenzen von mehr als 1 cm wurden bei insgesamt 19,6% der Kinder festgestellt, wobei die Gruppe der operierten Kinder etwa um das Doppelte überwog. Das Ausmaß des Längenzuwachses nimmt bei anhaltender Unruhe im Frakturbereich zu, so etwa nach mehreren Repositionen oder sekundärer Verplattung. Bezüglich einer verbliebenen Achsabweichung ließ sich eine eindeutige dominanz der konservativ behandelten Gruppe nachweisen, wobei eine Antekurvation bei weitem am häufigsten angetroffen wurde. Rotationsfehler stärkeren Ausmaßes fanden sich ebenso lediglich in der Gruppe der extendierten Kinder, besonders nach Schluß der Epiphysenfuge. Als schwerwiegende Komplikationen wurden bei den operierten Kindern zehnmal eine Refraktur, teils mit Plattenbruch, dreimal eine lokale Wundinfektion und einmal eine Osteomyelitis beobachtet, die inzwischen ausgeheilt ist. Zusammenfassend wird der Stellenwert der Druckplattenosteosynthese zur Behandlung der kindlichen Oberschenkelschaftfraktur im Vergleich zur konservativen Therapie herausgearbeitet. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |